Scoliosis is the curvature of the spine which gives it an "S" or “C”-shaped appearance when looking directly at the person's back. It is therefore a sideways curvature which can cause issues such as difficulties with breathing, if the condition is severe, as the curvature reduces space in the chest cavity.
Scoliosis tends to occur just before puberty when the affected person experiences a growth spurt. Conditions that are associated with scoliosis include muscular dystrophy (MD) and cerebral palsy (CP) which are neurological conditions affecting the large muscle groups. The causes of most scoliosis cases though is not known, but it is thought that issues such as birth defects which affect the development of the bones of the spine as well as injuries or infections of the spinal bones may be involved.
Signs and symptoms of scoliosis
Signs and symptoms of scoliosis may include the following:
- Asymmetry of the back.
- Shoulders that are uneven.
- One shoulder blade seems to be more pronounced than the other.
- Waist line is uneven.
- One hip seems to be higher than the other.
- In severe cases, the ribs on one side of the body can protrude.
- Back pain.
- Difficulty breathing.
Scoliosis treatment options
Regarding treatment of scoliosis, patients with mild cases are monitored conservatively by being followed up by an orthopedic surgeon every 4-6 months and having done serial X-rays of the spine. This allows the specialist to assess whether the curvature is stable or increasing. Here, no treatment is necessary and in moderate cases the patient will need to wear a brace to try and stop the curvature from worsening.
In severe cases surgery may be needed to correct the curvature of the spine and is done when the bones of the patient have stopped growing. This surgery includes performing a spinal fusion of the bones where 2 or more vertebrae are connected together in order that the bones can’t move independently. Screws, hooks or rods are placed to hold the spine straight and pieces of bone or alternate material is inserted between the bones. This helps to fuse the bones together so that the spine is straighter.
Other factors which determine which treatment protocols are used include the following:
- Gender – female’s risk progression is higher than in males.
- Curvature severity – larger curves tend to worsen over time.
- Pattern of the curve – “S”-shaped curves tend to worsen as compared to “C”-shaped curves.
- Location of the curve – if the curve is located in the thoracic area (middle) of the spine then this curve will tend to worsen more than those situated higher up or lower down on the spine.
- Growth plate maturity of the spinal bones – if the patient’s growth plates have closed then the risk of the curve progressing is lowered.
Braces will be used until these growth plates have closed. At home, patients should try and keep physically active as these activities help improve general well-being and health. The back muscles are also strengthened which helps to keep the spine stable and electrical stimulation of these muscles can also help improve their function.
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